Inspection A For the 2012 calendar year, or tax year beginning JUL 1, 2012 and ending ^7IJN 30, 2013 B check if

Size: px
Start display at page:

Download "Inspection A For the 2012 calendar year, or tax year beginning JUL 1, 2012 and ending ^7IJN 30, 2013 B check if"

Transcription

1 cjj C, m 0chan9 THE MIDORI FOUNDATION, INC. adhaannge Doing Business As MIDORI AND FRIENDS ^retum Number and street (or P.O. box if mail is not delivered to street address) Room/swte E Telephone number flat^'n- 352 SEVENTH AVENUE = Amended return City, town, or post office, state, and ZIP code G Gross receipts $ 1, 166, 859. Ot ni"a- NEW YORK, NY H(a) Is this a group return pending F Name and address of principal officer:suzanne WILSON for affiliates? =Yes No SAME AS C ABOVE H(b) Are all affiliates included? 0 Yes 0 No I Tax-exem p t status: 501 ( c )( 3 ) c 1 ( insert no. ) L 4947 ( a ) ( 1 ) or [:J 527 If 'No,' attach a list (see instructions) J Website : lo, MIDORIANDFRIENDS. ORG H (c ) Group exem ption number f^cc' Form 990 ' Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax OMB No Under section 501(c ), 527, or 4947( a)(1) of tie Internal Revenue Code (except black lung 2012 benefit trust or pr ivate foundation ) Open to Public The organization may have to use a copy of this return to satisfy state reporting requirem ents. Inspection A For the 2012 calendar year, or tax year beginning JUL 1, 2012 and ending ^7IJN 30, 2013 B check if applicable C Name of organization D Employer identification number K Form of or ganization: Corporation Q Trust Association 0 Other 0- L Year of formation: M State of le g al domicile: DE Part I Summary U c 1 Briefly describe the organization ' s mission or most significant activities : SEE SCHEDULE 0 2 Check this box D if the organization discontinued its operations or disposed of more than 25% of as net assets. 0 3 Number of voting members of the governing body (Part VI, line 1 a) Cd 4 Number of independent voting members of the governing body (Part VI, line 1 b) Total number of individuals employed in calendar year 2012 (Part V, One 2a) Total number of volunteers (estimate if necessary) 6 16 a 7 a Total unrelated business revenue from Part Vlll, column (C), line 12 7a 0. b Net unrelated business taxable income from Form 990-T, he 34 7b 0. Prior Year Current Year 8 Contributions and grants (Part VIII, line 1 h ) , , Program service revenue (Part VIII, line 2g ) 232, , 850. QZ 10 Investment Income (Part VIII, column (A), lines 3, 4, and 7d) 2, Other revenue (Part VII I, column (A), lines 5, 6d, 8c, 9c, 10c, and 11 e) -17, , Total revenue - add lines 8 throug h 11 (must eq ual Part VIII, column line 12) 1, 162, , 100, Grants and similar amounts paid (Part IX, column (A), lines 1-3) _ Benefits paid to or for members (Part IX, column (A), line 4) :... a I w 15 Salaries, other compensation, employee benefits (Part IX, colurnri (A), Vries -5:10)'F O) ' 778, , a Professional fundraising fees (Part IX, column (A), line 11 e)_- ^ 26, , 276. a b Total fundraisin g expenses (Part IX, column (D), line 25 ) 1 "' 2-3''? 9 42 W 17 Other expenses (Part IX, column (A), lines 11 a-11 d, 11 1f-24e) 616, , Total expenses Add lines (must equal Part IX, column (A), line 25) -..., 1, 421, , 197, Revenue less expenses. Subtract line 18 from One , , 579. Be g innin g of CurrentYear End of Year y 20 Total assets (Part X, line 16) 1, 479, , Total liabilities (Part X, One 26) 71, , i. 22 Net assets or fund balances. Subtract line 21 from One , 333. I Part II 1 Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. De atlon of preparer ( other than officer ) is based on all information of which preparer has any know) dge Sign Signatu of officer Here ' Typ A" v^ 2 - W A..n.) or print name and title Print/Type preparer ' s name Prepa sig Paid LAUREN CRESCI 4. 1 Preparer Firm's name lik LUTZ AND CARR P LLP Use Only Firm's address, 300 EAST 42ND STREET LHA For Paperwork Reduction Act Notice, see the

2 Form THE MIDORI FOUNDATION INC ' Pa e2' Part III Statement of Program Service Accomplishments Check if Schedule 0 contains a response to any question in this Part III 1 Briefly describe the organization's mission- THE MIDORI FOUNDATION PROVIDES MUSIC EDUCATION PROGRAMS TO NEW YORK CITY SCHOOLS AT NO CHARGE TO THE INDIVIDUAL STUDENTS. 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? If 'Yes,' describe these new services on Schedule 0. Yes No 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services? =Yes No If 'Yes,' describe these changes on Schedule 0. 4 Describe the organization ' s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501 (c)(3) and 501 (c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. 4a (Code ) (Expenses $ 856,799. including grants of $ ) (Revenue $ 198,850. FOUNDED IN 1992 BY WORLD-RENOWNED VIOLINIST MIDORI AND A DEVOTED BOARD OF DIRECTORS, MIDORI & FRIENDS PROVIDES A DIVERSE MENU OF MUSIC EDUCATION PROGRAMS TO CHILDREN AND TEENS IN PUBLICLY FUNDED SCHOOLS WITHIN NEW YORK CITY. THE ORGANIZATION IS PRIMARILY KNOWN FOR TWO FLAGSHIP PROGRAMS OFFERED AS LONG- TERM, SCHOOL-BASED RESIDENCIES: SEQUENTIAL, STANDARDS-BASED INSTRUCTION IN INSTRUMENTAL AND VOCAL MUSIC PROVIDED BY PROFESSIONAL TEACHING ARTISTS; AND CLASSROOM WORKSHOPS IN A WIDE VARIETY OF MUSICAL GENRES LED BY ACCLAIMED PERFORMING ENSEMBLES THAT CULMINATE WITH STUDENTS PERFORMING ON STAGE ALONGSIDE THE PROFESSIONAL ARTISTS. MUSIC ENRICHMENT IS CUSTOMIZED FOR EACH SCHOOL PARTNER BASED ON THE SCHOOL ADMINISTRATION'S VISION OF ARTS EDUCATION FOR ITS STUDENTS; ALL PROGRAMS ARE ALIGNED WITH THE FIRM PHILOSOPHY OF 4b (Code ) (Expenses $ including grants of $ ) (Revenue $ 4c (Code- ) (Expenses $ including grants of $ ) (Revenue $ 4d Other program services (Describe in Schedule 0.) (Expenses $ including grants of S ) (Revenue $ 4e Total program service expenses 856,799. Form 990 (2012) SEE SCHEDULE 0 FOR CONTINUATION(S) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

3 Part IV I Cheoklist of Required Schedules ' 1 Is the organization described in section 501 (c)(3) or 4947(a)(1) (other than a private foundation)' If 'Yes,' complete Schedule A Is the organization required to complete Schedule B, Schedule of Contributos? 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If 'Yes,' complete Schedule C, Part 4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If 'Yes,' complete Schedule C, Part II... 5 Is the organization a section 501 (c)(4), 501 (c)(5), or 501 (c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If 'Yes,' complete Schedule C, Part III 6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part /I. 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If 'Yes," complete Schedule D, Part Ill 9 Did the organization report an amount in Part X, One 21, for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If 'Yes," complete Schedule D, Part IV Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If 'Yes," complete Schedule D, Part V If the organization's answer to any of the following questions is 'Yes,' then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable. a Did the organization report an amount for land, buildings, and equipment in Part X, One 10? If 'Yes,' complete Schedule D, Part VI b Did the organization report an amount for investments - other securities in Part X, One 12 that is 5% or more of its total assets reported in Part X, One 16? If "Yes," complete Schedule D, Part VII c Did the organization report an amount for investments - program related in Part X, One 13 that is 5% or more of its total assets reported in Part X, One 16? If 'Yes, " complete Schedule D, Part VIII d Did the organization report an amount for other assets in Part X, One 15 that is 5% or more of its total assets reported in Part X, line 16' If "Yes," complete Schedule D, Part IX e Did the organization report an amount for other liabilities in Part X, One 25? If 'Yes," complete Schedule D, Part X f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If 'Yes,' complete Schedule D, Part X 12a Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete Schedule D, Parts Xl and XII b Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No' to line 12a, then completing Schedule D, Parts XI and Xll is optional Is the organization a school described in section 170(b)(1)(A)(ii)? If 'Yes," complete Schedule E 14a Did the organization maintain an office, employees, or agents outside of the United States? b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV 15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If 'Yes,' complete Schedule F, Parts II and IV 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If "Yes, " complete Schedule F, Parts Ill and IV 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11 e? If 'Yes, " complete Schedule G, Part I 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1 c and 8a' If "Yes,' complete Schedule G, Part II 19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If 'Yes, " complete Schedule G, Part III 20a Did the organization operate one or more hospital facilities? If 'Yes,' complete Schedule H b If "Yes' to line 20a, did the organization attach a copy of its audited financial statements to this return I 2 X 3 X 4 X 9 X 10 X 11a lib 11c 11d X 17 X 18 X X X X X 19 X 20a X 20b Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

4 Part IV Checklist of Required Schedules (continued) 21 Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If 'Yes," complete Schedule 1, Parts I and X 22 Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If "Yes,' complete Schedule 1, Parts I and Ill 22 X 23 Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current 24a and former officers, directors, trustees, key employees, and highest compensated employees? If 'Yes,' complete Schedule J X Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If *Yes," answer lines 24b through 24d and complete Schedule K. If 'No', go to line 25 24a X b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? b c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? d Did the organization act as an 'on behalf of" issuer for bonds outstanding at any time during the year? d 25a Section 501(c )(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes,' complete Schedule L, Part I 25a X b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If "Yes,' complete Schedule L, Part I 25b X 26 Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization's tax year's If 'Yes,' complete Schedule L, Part X 27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes,' complete Schedule L, Part Ill X 28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): a A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV a X b A family member of a current or former officer, director, trustee, or key employee? If "Yes,' complete Schedule L, Part IV 28b X c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV 28c X 29 Did the organization receive more than $25,000 in non-cash contributions? If 'Yes," complete Schedule M 29 X 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contnbutions' If 'Yes," complete Schedule M X 31 Did the organization liquidate, terminate, or dissolve and cease operations? If 'Yes,' complete Schedule N, Part/ X 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?/f 'Yes," complete Schedule N, Part II 32 X 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections and ? If "Yes," complete Schedule R, Part I X 34 Was the organization related to any tax-exempt or taxable entity? If "Yes,' complete Schedule R, Part fl, Ill, or IV, and Part V, ffne X 35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? 35a X b If "Yes" to fine 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If 'Yes,' complete Schedule R, Part V, Erie 2..,.. 35b 36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-chantable related organization? If 'Yes,' complete Schedule R, Part V, Erie 2 36 X 37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes,' complete Schedule R, Part VI X 38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 11 b and 19? Note. All Form 990 filers are required to complete Schedule 0 1 X Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

5 Form THE MIDORI FOUNDATION INC ' Pa e 5 ' Part V Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule 0 contains a response to any question in this Part V 1a Enter the number reported in Box 3 of Form Enter -0- if not applicable la 25 b Enter the number of Forms W-2G included in line 1 a. Enter -0- if not applicable lb 0 c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming 2a (gambling) winnings to prize winners? c Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return 2a 46 b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? 2b X Note. If the sum of lines 1 a and 2a is greater than 250, you may be required to e-file (see instructions) 3a Did the organization have unrelated business gross income of $1,000 or more during the year? 3a X b If 'Yes,' has it filed a Form 990-T for this year? If 'No,' provide an explanation in Schedule ,,.. 3b 4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)',, 4a X b If 'Yes,' enter the name of the foreign country: 0, See instructions for filing requirements for Form TD F , Feport of Foreign Bank and Financial Accounts. 5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? 5a X b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?, b X c If Yes,' to line 5a or 5b, did the organization file Form 8886-T? 5c 6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? 6a X b If Yes,' did the organization include with every soicitt ation anexpress statement that such contributions or gifts were not tax deductible? 7 Organizations that may receive deductible contributions under section 170(c). a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor' 7a X b If Yes,' did the organization notify the donor of the value of the goods or services provided? b X c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? 7c X d If Yes,' indicate the number of Forms 8282 filed during the year 7d e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? - 7e X f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 7f X g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?.,. 7 In If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? 7h 8 Sponsoring organizations maintaining donor advised funds and section 509(a )( 3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year? 8 9 Sponsoring organizations maintaining donor advised funds. a Did the organization make any taxable distributions under section 4966? --, 9a b Did the organization make a distribution to a donor, donor advisor, or related person? 9b 10 Section 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on Part VIII, line 12,, 10a b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities , 10b 11 Section 501(c )( 12) organizations. Enter: a Gross income from members or shareholders... 11a b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) b 12a Section 4947(a)(1) non - exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? 12a b If Yes,' enter the amount of tax-exempt interest received or accrued during the year b 13 Section 501(c )( 29) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? a Note. See the instructions for additional information the organization must report on Schedule 0. b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans., b c Enter the amount of reserves on hand 13c 14a Did the organization receive any payments for indoor tanning services during the tax year?,,,-,- -,,,,, a X b If 'Yes.' has it filed a Form 720 to report these oavments? If 'No.' crovide an exolanat on in Schedule 0 14b 6b Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

6 . ' Form 996 (2012) TH E MIDORI FOUNDATION, INC ' Paae 6 ' Part VI Governance, Management, and Disclosure For each 'Yes' response to lines 2 through 7b below, and fora 'No" response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions. Check if Schedule 0 contains a response to any question in this Part VI EX] Section A. Governing Body and Management la Enter the number of voting members of the governing body at the end of the tax year la 16 If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule 0. b Enter the number of voting members included in line la, above, who are independent. - - lb 16 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? 2 X 3 Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? 3 X 4 Did the organization make any significant changes to its governing documents since the pnor Form 990 was filed? 4 X 5 Did the organization become aware during the year of a significant diversion of the organization's assets?... 5 X 6 Did the organization have members or stockholders? 7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? 7b X 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body? 8a X b Each committee with authority to act on behalf of the governing body? 8b X 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If "Yes " provide the names and addresses in Schedule 0 9 X Section B. Policies (This Section B requests information about policies no t required by the Internal Revenue Code.) 10a Did the organization have local chapters, branches, or affiliates? 10a X b If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?. - 10b I la Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? 11a X b Describe in Schedule 0 the process, if any, used by the organization to review this Form a Did the organization have a written conflict of interest policy? If 'No," go to line 13 12a X b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? 12I X c Did the organization regularly and consistently monitor and enforce compliance with the policy? If 'Yes," describe in Schedule 0 how this was done 12c X 13 Did the organization have a written whistleblower policy? X 14 Did the organization have a written document retention and destruction policy? X 15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official... b Other officers or key employees of the organization 15b X If "Yes" to line 15a or 15b, describe the process in Schedule 0 (see instructions). 16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? 16a X b If 'Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exem p t status with res pect to such arrangements? 16b Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to be filed NY, DE 18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable ), 990, and 990-T (Section 501 (c)(3)s only) available for public inspection. Indicate how you made these available Check all that apply. Own website E] Another' s websrte Upon request 0 Other (explain in Schedule 0) 19 Describe in Schedule 0 whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. 20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization: 00. GREG PIERSON SEVENTH AVENUE, SUITE 301, NEW YORK, NY Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1 15a X

7 Form 99b 012 THE MIDORI FOUNDATION INC ' Pa e 7' Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Check rf Schedule 0 contains a response to any question in this Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees la Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization ' s tax year. List all of the organization ' s current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. List all of the organization ' s current key employees, if any. See instructions for definition of 'key employee.' List the organization ' s five current highest compensated employees ( other than an officer, director, trustee, or key employee ) who received reportable compensation ( Box 5 of Form W-2 and /or Box 7 of Form 1099-MISC ) of more than $ 100,000 from the organization and any related organizations. List all of the organization ' s former officers, key employees, and highest compensated employees who received more than $ 100,000 of reportable compensation from the organization and any related organizations. List all of the organization ' s former d irectors or trustees that received, in the capacity as a former director or trustee of the organization, more than $ 10,000 of reportable compensation from the organization and any related organizations. List persons in the following order : individual trustees or directors ; institutional trustees ; officers; key employees ; highest compensated employees; and former such persons. = Check this box if neither the organ ization nor any related organization compensated any current officer directnr or to jstpp (A) Name and Title (B) Average hours per week (list any (1) MIDORI hours for related organizations below line) - o (C) Position (do not check more than one box, unless person is both an officer and a director/trustee ). E Y E E (D) Reportable compensation from the organization (W-2/1099-MISC) (E) Reportable compensation from related organizations (W-2/1099-MISC) (F) Estimated amount of other compensation from the organization and related organizations FOUNDER AND PRESIDENT EMERITUS X (2) MARILYN COHEN VICE CHAIR X (3) LORI ANNE CZEPIEL 1.00 BOARD MEMBER X (4) ALAN FISCHER 1.00 BOARD MEMBER AND CHAIRMAN EMERITUS X 0. 0, 0. - (5) LARAINE FISCHER 1.00 BOARD MEMBER X 0. 0, 0. - (6) PETER GLASER 1.00 CHAIR X (7) DANIEL GOLDHAGEN 1.00 BOARD MEMBER X (8) KATYA GORBATIOUK 1.00 BOARD MEMBER X (9) SETSU GOTO 1.00 FOUNDING MEMBER X (10) DEANNA LANDIVAR-RUIZ BOARD MEMBER X (11) ROBERT MERRELL 1.00 BOARD MEMBER X (12) JILL KLINOW JAFFE 1.00 CHAIR EMERITI X (13) MARC RICHTER 1.00 BOARD MEMBER X (14) GEETA SHARMA, M.D 1.00 SECRETARY X (15) MIKE SMITH 1.00 BOARD MEMBER X (16) YVETTE AUSTIN SMITH 1.00 TREASURER X (17) MAKIKO TANAKA 1.00 BOARD MEMBER X Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

8 Form THE MIDORI FOUNDATION INC ' Page 8' Part VII Section A Officers Directors Trustees Key Em Io ees and Ht hest Com ensated Em ploye s continued (A) Name and title (B) Average hours per week (list any hours for related organizations below line) (C) Position (do not check more than one box, unless person is both an officer and a d rector/trustee ) m ; =e r 5 5 o - E (D ) Reportable compensation from the organization (W-2/1099-MISC) (E) Reportable compensation from related organizations (W-2/1099-MISC) (F) Estimated amount of other compensation from the organization and related organizations (18) JUDITH LINDEN PRESIDENT X 65, (19) SUZANNE WILSON EXECUTIVE DIRECTOR X 79, (20) DENNIS CONROY DIRECTOR OF FINANCE X 44, (21) GREGORY PIERSON DIRECTOR OF FINANCE X 19, b Sub -total 208, c Total from continuation sheets to Part VII, Section A d Total add lines lb and 1c 208, , Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable 3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line 1 a? If 'Yes, ' complete Schedule J for such individual 4 For any individual listed on line 1 a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If 'Yes,' complete Schedule J for such individual. 5 Did any person listed on line 1 a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If 'Yes.' comolete Schedule J for such person Section B. Independent Contractors 1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year (A) Name and business address NONE (B) Description of services (C) Compensation 0 No 2 Total number of independent contractors (including but not limited to those listed above) who received more than $ 100, 000 of com pensation from the organization 0 Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

9 Form THE MIDORI FOUNDATION INC Page 9 Part VIII Statement of Revenue Check if Schedule 0 contains a response to any question in this Part VIII F-1 (A) B Total revenue Related or Unrelated Revenu eex cluded exempt function business from tax under sections 512, 00 a C 1 a Federated campaigns 1a o b Membership dues 1b y c Fundraising events.... 1c Q I d Related organizations 1d 115, 580. v;f e Government grants (contributions) 1e 414, 294. Y f All other contributions, gifts, grants, and d ^o Z o similar amounts not included above --- 1f 369, Noncash contributions included in lines la-1t $ 991. U h Total. Add lines 1 a-1 f , 773. Business Code 0 2a EDUCATION REVENUE b ch c m d f All other program service revenue Total. Add lines 2a-2f lip, 198, Investment income (including dividends, interest, and other similar amounts) Income from investment of tax-exempt bond proceeds 5 Royalties a Gross rents - b Less: rental expenses - c Rental income or Qoss) - i Real n Personal d Net rental income or (loss) 7 a Gross amount from sales of 1 Securities n Other assets other than inventory b c Less: cost or other basis and sales expenses Gain or Qoss) d Net gain or Qoss) d S a Gross income from fundraising events (not including $ 115,580. of contnbutions reported on line 1c). See Part IV, line 18 a 66, 183. t b Less direct expenses. b 66, 183. c Net income or (loss) from fundraising events 0. 9 a Gross income from gaming activities See Part IV, line a b Less- direct expenses b c Net income or (loss) from gaming activities - 10 a Gross sales of inventory, less returns and allowances a b Less cost of goods sold - b c Net income or oss from sales of invento ry Miscellaneous Revenue Business Code revenue revenue 513 or a OTHER REVENUE , , 053. b c d All other revenue e Total. Add lines 11a 11d - _ 2, Total revenue. See instructions. - 1, 100, , , 053o Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

10 I Part IX I Statement of Functiona l Expenses Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A). Check if Schedule 0 contains a response to any question in this Part IX Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 106 of Part Vlll. 1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 2 Grants and other assistance to individuals in the United States See Part IV, line 22 3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 4 Benefits paid to or for members _ Total expenses Program service expenses Management and g eneral expenses 'Pacie10 ' FundD)sing ex penses 5 Compensation of current officers, directors, trustees, and key employees 242, , , Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)... 7 Other salaries and wages 370, , , , Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) , , Other employee benefits 47, , , Payroll taxes.. 66, , , , a Fees for services (non-employees) Management b Legal , c Accounting d Lobbying e Professional fundraising services. See Part IV, line f Investment management fees g Other. (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 1lg expenses on Sch 0.) Advertising and promotion Office expenses.. _ Information technology _ 15 Royalties 16 Occupancy Travel Payments of travel or entertainment expenses for any federal, state, or local public officials 19 Conferences, conventions, and meetings _ 20 Interest 21 Payments to affiliates 22 Depreciation, depletion, and amortization Insurance Other expenses. Itemize expenses not covered above. (List miscellaneous expenses In line 24e. It line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule 0.) a MISCELLANEOUS EXPENSES b INDIRECT BENEFIT EXPENS c MEALS AND ENTERTAINMENT d SCHOLARSHIP PROCESSING e All other expenses Total functional ex enses. Add lines 1 throw h 24e , , , Joint costs. Complete this line only if the organization reported in column (B) point costs from a combined educational campaign and fundraising solicitation. Check here 01 O if followin g SOP 98-2 ASC ) Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

11 Check if Schedule 0 contains a res ponse to an y question in this Part X (A) Beginning of year 1 Cash - non-interest-bearing -- 1 (B) End of year 2 Savings and temporary cash investments 980, , Pledges and grants receivable, net , , Accounts receivable, net , Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L 6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501 (c)(9) voluntary employees' beneficiary organizations (see instr). Complete Part II of Sch L 6 y 7 Notes and loans receivable, net 7 8 Inventories for sale or use 8 9 Prepaid expenses and deferred charges 9, , a Land, buildings, and equipment. cost or other basis Complete Part VI of Schedule D a 56, 932. b Less: accumulated depreciation..- -, -- 10b 42, , 070. loc 14, Investments - publicly traded secunties Investments - other securities. See Part IV, line Investments - program-related. See Part IV, line Intangible assets Other assets. See Part IV, line 11 17, Total assets. Add lines 1 throw h 15 must ual line , 375, Accounts payable and accrued expenses , , Grants payable Deferred revenue Tax-exempt bond liabilities Escrow or custodial account liability. Complete Part IV of Schedule D 21 '-' 22 Loans and other payables to current and former officers, directors, trustees, M key employees, highest compensated employees, and disqualified persons J Complete Part II of Schedule L Secured mortgages and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third parties Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D Total liabilities. Add lines 17 throug h 25 71, , 983. Organizations that follow SFAS 117 (ASC 958), check here and U) complete lines 27 through 29, and lines 33 and Unrestricted net assets... 1, 190, , 186, 333. M 28 Temporarily restricted net assets 217, , 000. V 29 Permanently restricted net assets 29 LL Organizations that do not follow SFAS 117 (ASC 958), check here 00, o and complete lines 30 through Capital stock or trust principal, or current funds 30 Q 31 Paid-in or capital surplus, or land, building, or equipment fund Retained earnings, endowment, accumulated income, or other funds 32 Z 33 Total net assets or fund balances 1, 407, , 311, Total liabilities and net assetstfund balances 1, 479, , 375, 316. Form 990 (2012) MIDORI THE MIDORI FOUNDATION, INC. MIDORI 1

12 Part XI I Reconciliation of Net Assets Check if Schedule 0 contains a response to any question in this Part XI LI 1 Total revenue (must equal Part VIII, column (A), line 12) , 100, Total expenses (must equal Part IX, column (A), line 25) , Revenue less expenses. Subtract line 2 from line , Net assets or fund balances at beginning of year (must equal Part X, One 33, column (A)) , 407, Net unrealized gains Qosses ) on investments 5 6 Donated services and use of facilities 6 7 Investment expenses 7 8 Prior period adjustments 9 Other changes in net assets or fund balances (explain in Schedule 0) Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column..... Part XII Financial Statements and Reporting 10, 1, 311, 333. Check if Schedule 0 contains a res ponse to any q uestion in this Part XII Yes No 1 Accounting method used to prepare the Form Cash Accrual 0 Other 2a If the organization changed its method of accounting from a pnor year or checked 'Other," explain in Schedule O. Were the organization's financial statements compiled or reviewed by an independent accountant? If "Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: 0 Separate basis Q Consolidated basis 0 Both consolidated and separate basis b Were the organization ' s financial statements audited by an independent accountant? If "Yes,' check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: Separate basis LI Consolidated basis 0 Both consolidated and separate basis c If 'Yes' to One 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant'? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule 0 3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? b If 'Yes, " did the organization undergo the required audit or audits? If the organization did not undergo the required audit 12' Form 990 (2012) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

13 SCHEbULE A OMB No (Form 990 or 990 F^ Public Charity Status and Public Support Complete if the organization is a section 501(c )( 3) organization or a section 2012 Department of the Treasury 4947( a)(1) nonexempt charitable trust. Open to Public Internal Revenue Service 110- Attach to Form 990 or Form 990 -EZ. 0- See separate instructions. Inspection Name of the organization Employer identification number THE MIDORI FOUNDATION,INC Part I I Reason for Public Charity Status (All organizations must complete this part.) See Instructions. The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.) 1 A church, convention of churches, or association of churches described in section 170 ( b)(1)(a)(i). 2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.) 3 A hospital or a cooperative hospital service organization described in section 170 (b)(1)(a)(iii). 4 A medical research organization operated in conjunction with a hospital described in section 170 (b)(1)(a)(iii). Enter the hospital's name, city, and state: 5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170 (b)(1)(a)(iv). (Complete Part II.) 6 A federal, state, or local government or governmental unit described in section 170 ( b)(1)(a)(v). 7 An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170 (b)(1)(a)(vi ). (Complete Part II.) 8 A community trust described in section 170 ( b)(1)(a)(vi ). (Complete Part II ) 9 0 An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income Bess section 511 tax) from businesses acquired by the organization after June 30, See section 509(a )(2). (Complete Part III.) 10 0 An organization organized and operated exclusively to test for public safety. See section 509(a)(4). 11 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2) describes the type of supporting organization and complete lines 11 a through 11 h. See section 509(a)(3). Check the box that a0 Type I b E] Type II c Type III - Functionally integrated d = Type III - Non-functionally integrated e By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a )( 1) or section 509(a)(2) f If the organization received a written determination from the IRS that it is a Type I, Type 11, or Type III g h supporting organization, check this box - Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons described in ( iii) and (I) below, Yes No the governing body of the supported organization? i (ii) A family member of a person described in n above? 11 ii (iii) A 35% controlled entity of a person described in () or n above?. Provide the following information about the supported organization(s). (i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1-9 above or IRC section (see instructions )) iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your supports (vi) Is the organization in col. (i) organized in the U.S.? Yes No Yes No Yes No (vii) Amount of monetary support Total LHA For Paperwork Reduction Act Notice, see the Instructions for Schedule A (Form 990 or 990-EZ) 2012 Form 990 or 990-EZ MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

14 Schedule A (Form 990 or 990-EZ) 2012 THE MIDORI FOUNDATION, INC ' Paae 2 Part II Support Schedule for Organizations Described in Sections 170(b)( 1)(A)(iv) and 170 (b)(1)(a)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Pat I or rf the organization failed to qualify under Part III If the organization fails to qualify under the tests listed below, please complete Part III.) Secti on A. Public Support Calendar year ( or fiscal year beginning in) ( a ) 2008 (b ) 2009 c 2010 ( d ) 2011 (e) 2012 Total 1 Gifts, grants, contributions, and membership fees received. (Do not include any"unusual grants. ) , Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 3 The value of services or facilities furnished by a governmental unit to the organization without charge 4 Total. Add lines 1 through The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (fl 388, Public su art. Subtract line 5 from line Section B. Total Support Calendar year ( or fiscal year beginning in) 7 Amounts from line 4 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources 9 Net income from unrelated business activities, whether or not the business is regularly camed on Other income. Do not include gain or loss from the sale of capital (a) 2008 (b ) 2009 c 2010 ( d ) 2011 (e) 2012 Total , assets (Explain in Part IV.) 11 Total support Add lines 7 through Gross receipts from related activities, etc. (see instructions ) First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here 0 Section C. Com putation of Public Support Percentage 14 Public support percentage for 2012 (line 6, column (t) divided by line 11, column (f)) Public support percentage from 2011 Schedule A, Part II, line % 16a 33 1 /3% support test If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization b 33 1 /3% support test If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization Q 17a 10% -facts - and-circumstances test If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and If the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part IV how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization b 10% -facts - and-circumstances test If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and If the organization meets the 'facts-and-circumstances' test, check this box and stop here. Explain in Part IV how the organization meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization 18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions. oo. E] Schedule A (Form 990 or 990-EZ) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

15 Schedule A Form 990 or 990-E 2012 Page 3 Part III Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II ) Section A. Public Support Calendar year ( or fiscal year beginning in) (a) 2008 (b) 2009 c 2010 ( d ) 2011 (e ) 2012 Total 1 Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.') 2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose 3 Gross receipts from activities that are not an unrelated trade or business under section Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 5 The value of services or facilities furnished by a governmental unit to the organization without charge 6 Total. Add lines 1 through a Amounts included on lines 1, 2, and 3 received from disqualified persons b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year c Add lines 7a and 7b 8 Public supp ort ( Subtract line 7c from line 6 Section B. Total Support Calendar year (or fiscal year beginning in) 9 Amounts from line 6 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 a 2008 (b) 2009 c 2010 (d) 2011 a 2012 Total c Add lines 1 Oa and 1 Ob Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) 13 Total support. (Add lines 9, 10c, 11, and 12) 14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here Section r.cmmnutatinn of Pnhlir _Stinnnrt PercPntanc 0 Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2012 Qlne 1 Oc, column (f) divided by line 13, column (f)) 17 % 18 Investment income percentage from 2011 Schedule A, Part III, line % 19a 33 1 /3%a support tests If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization b 33 1 /3% support tests If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization - D 20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions Schedule A (Form 990 or 990 -EZ) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

16 SCHEDULED Supplemental Financial Statements (Form 990) 10- Complete if the organization answered "Yes," to Form 990, Department of the Treasury Internal Revenue Service Name of the organization Part IV, line 6, 7, 8, 9, 10, 1la, 11b, 11c, 11d, 1le, 11f, 12a, or 12b. Attach to Form 990. OPP- See separate instructions Open to Public I Employer identification number THE MIDORI FOUNDATION INC Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Completed the organization answered 'Yes' to Form 990, Pat IV, line 6. (a) Donor advised funds (b) Funds and other accounts 1 Total number at end of year Aggregate contributions to (during year) 3 Aggregate grants from (during year) 4 Aggregate value at end of year... 5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control? Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring El Yes 0 No Part II I Conservation Easements. Complete if the organization answered "Yes' to Form 990, Part IV, line 7. 1 Purpose (s) of conservation easements held by the organization (check all that apply). Preservation of land for public use (e.g, recreation or education ) 0 Preservation of an historically important land area Protection of natural habitat 0 Preservation of open space Preservation of a certified historic structure 2 Complete lines 2a through 2d tf the organization held a qualified conservation contribution in the form of a conservation easement on the last a b day of the tax year. Total number of conservation easements Total acreage restricted by conservation easements c Number of conservation easements on a certified historic structure included in (a) - -. d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register - 3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year llo- 4 Number of states where property subject to conservation easement is located 5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? El Yes 0 No 6 Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year 7 Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year $ 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)() and section 170(h)(4)(B)()' Yes E] No 9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization ' s financial statements that describes the organization's accounting for conservation easements Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered ' Yes' to Form 990, Pat IV, line 8. la If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items. b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items. (i) Revenues Included in Form 990, Part VIII, line $ (ii) Assets Included in Form 990, Part X $ 2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items: a Revenues Included in Form 990, Part VIII, line 1 $ b Assets Included in Form 990, Part X $ LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

17 Schedule D (Form 990) 2012 THE MIDORI FOUNDATION, INC ' Paae 2' Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets(continued) 3 Using the organization ' s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply): a C^ Public exhibition d Loan or exchange programs b 0 Scholarly research e Other c Preservation for future generations 4 Provide a description of the organization ' s collections and explain how they further the organization ' s exempt purpose in Part XIII. 5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as part of the org anization ' s collection? 0 Yes 0 No Part IV Escrow and Custodial Arrangements. Complete if the organization answered " Yes" to Form 990, Pat IV, line 9, or reported an amount on Form 990, Part X, line 21. la Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X?. 0 Yes 0 No b If 'Yes," explain the arrangement in Part XIII and complete the following table: c Beginning balance Amount d Additions during the year. e Distributions during the year f Ending balance a Did the organization include an amount on Form 990, Part X, One 21? 0 Yes No b If 'Yes. ' exp lain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII 0 PartV Endowment Funds. Complete if the organization answered 'Yes" to Form 990, Part IV, line 10. la b c d e Beginning of year balance Contributions Net investment earnings, gains, and losses Grants or scholarships Other expenditures for facilities and programs f Administrative expenses. g End of year balance... 2 Provide the estimated percentage of the current year end balance (brie 1 g, column (a)) held as: 3a a Board designated or quasi-endowment % b Permanent endowment POP % c Temporarily restricted endowment 00- % The percentages in lines 2a, 2b, and 2c should equal 100%. (a) Current year (b ) Prior year (c) Two years back (d ) Three years back (e ) Four years back Are there endowment funds not in the possession of the organization that are held and administered for the organization by: Yes No (i) unrelated organizations a i (ii) related organizations a ii b If "Yes' to 3a(), are the related organizations listed as required on Schedule R? - 3b 4 Describe in Part XIII the intended uses of the organization's endowment funds. Part VI Land. Buildings. and Equipment. See Form 990. Part X. fine 10. la b Land Buildings Description of property c Leasehold improvements. (a) Cost or other basis (investment) (b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value d Equipment , 298. e Other Total. Add lines 1 a throw h 1 e (Column d must equal Form 990, Part X column B line 10 (c). ) 14, 298. Schedule D (Form 990) MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

18 -_.J..I, n ^..., nnnw nn1e rfit.tli MTT'CDT V/ITTTVT TTr T TTT/' A Part VII Investmen #s -Other Securities. See Form 990, Part X, line 12. (a) Description of security or category (including name of security) (b) Book value (c) Method of valuation Cost or end-of-year market value (1) Financial derivatives (2) Closely-held equity interests. _.... (3) Other (A) (B ) (C) (G) (H ) Total. Col. M must e q ual Form 990, Part X, cal. ( B ) line 12. ) Part VIII Investments - Program Related. See Form 990, Part X, One 13. (a) Description of investment type (b) Book value (c) Method of valuation: Cost or end-of-year market value Total. Col. b must e q ual Form 990, Part X, col. B line 13. ) Part IX Other Assets. See Form 990. Part X. line 15. (a) Description 1 (2 ) (3 ) (4 ) (5 ) (6 ) (b) Book value (8) (9) ( 10 ) Total. (Column must eq ual Form 990, Part X, col line 15 ) Part X Other Liabilities. See Form 990, Part X, fine (a) Description of liability (b) Book value ( 1 ) Federal income taxes (2) (3) (4) (5 ) (6) (8) (9) ( 10) ( 11 ) Total. Column must eq ual Form 990, Part X, col. line 25. ) 2. FIN 48 (ASC 740) Footnote In Part XIII, provide the text of the footnote to the organization 's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII _ Schedule D (Form 990) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

19 Schedule D (Form THE MIDORI FOUNDATION INC ' Pa e 4 Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return 1 Total revenue, gains, and other support per audited financial statements Amounts included on line 1 but not on Form 990, Part VIII, line 12. a Net unrealized gains on investments --- 2a b Donated services and use of facilities - 2b 37, 675. c Recoveries of prior year grants 2c d Other (Describe in Part XIII.) d e Add lines 2a through 2d.., - 2e 37, Subtract line 2e from line 1, - 3 1, 100, Amounts included on Form 990, Part VIII, line 12, but not on line 1: a Investment expenses not included on Form 990, Part VIII, line 7b -. 4a b Other (Descnbe in Part XIII.) 4b c Add lines 4a and 4b 4c 0. 5 Total revenue. Add lines 3 and 4c. his must equal Form 990, Part I line 12. ) , 676. Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return 1 Total expenses and losses per audited financial statements ,234, Amounts included on line 1 but not on Form 990, Pat IX, line 25: a Donated services and use of facilities a 37, 675. b Prior year adjustments b c Other losses 2c d Other (Describe in Part XIII) 2d e Add lines 2a through 2d.. 2e 37, Subtract line 2e from line 1 3 1, 1 9 7, Amounts included on Form 990, Part IX, One 25, but not on line 1 a Investment expenses not included on Form 990, Part VIII, line 7b 4a b Other (Describe in Part XIII.) 4b c Add lines 4a and 4b c 0. 5 Total expenses Add lines 3 and 4c. ri^ i' must equal Form 990, Part 1 line , 197, 255. Part XIII Supplemental Information Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines la and 4; Part IV, fines lb and 2b, Part V, line 4, Part X, line 2, Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information. PART X, LINE 2: MANAGEMENT HAS EVALUATED ALL INCOME TAX POSITIONS, INCLUDING THE POSITION THAT THE FOUNDATION IS EXEMPT FROM INCOME TAXES OR NOT SUBJECT TO INCOME TAXES ON UNRELATED BUSINESS INCOME, AND CONCLUDED THAT NO DISCLOSURES RELATING TO UNCERTAIN TAX POSITIONS ARE REQUIRED IN THE FINANCIAL STATEMENTS. Schedule D (Form 990) MIDORI THE MIDORI FOUNDATION,INC. MIDORI_1

20 ' SCHEDULE G Supplemental Information Regarding (Form 990 or 990-EZ) Fundraising or Gaming Activities Department of the Treasury internal Revenue Service Name of the organization Part I OMB No Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990 -EZ, line 6a. Open To Public Allo Attach to Form 990 or Form 990-EZ. See separate instructions. Inspection Employer identification number Fundraising Activities. Complete if the organization answered 'Yes' to Form 990, Pat IV, line 17. Form 990-EZ flers are not required to complete this pa rt. 1 Indicate whether the organization raised funds through any of the following activities. Check all that apply. a Mail solicitations e Q Solicitation of non-government grants b Internet and solicitations f Solicitation of government grants c Phone solicitations g Special fundraising events d In-person solicitations 2 a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? Yes No b If 'Yes,' list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be compensated at least $5, 000 by the organization. ( t) Name and address of individual or entity (fundraiser) ii) Activity have futndras^ cu stody «control buboof of contribu t io ns '? (iv) Gross receipts rom activity o((oramount p aid t retained b by) fundraiser listed in col (i) ( vi) Amount paid to (or retained by) org anization THE DREYFOOS GROUP PARK Yes No AVE SOUTH STE 301, NEW YORK REQUESTED FUNDING X , Total List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing. LHA Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990 -EZ. Schedule G (Form 990 or 990-EZ) 2012 SEE PART IV FOR CONTINUATIONS MIDORI THE MIDORI FOUNDATION,INC. MIDORI 1

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2010 benefit trust or private foundation)

More information

Form 990 Return of Organization Exempt From Income Tax

Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2011 benefit trust or private foundation)

More information

Form 990 Return of Organization Exempt From Income Tax

Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2014 Do not enter social security

More information

Open to Public Inspection A For the 2011 calendar year, or tax year beginning B Check if applicable: C Name of organization

Open to Public Inspection A For the 2011 calendar year, or tax year beginning B Check if applicable: C Name of organization Form 990 Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service For the 2011 calendar year, or tax year beginning, 2011, and ending, B Check if applicable: C D Employer Identification Number ddress change

More information

1. The organization mission or most significant activities that you wish to highlight this year:

1. The organization mission or most significant activities that you wish to highlight this year: Form 990 Questionnaire For All Organizations Core Form Heading & Pt I Summary 1. The organization mission or most significant activities that you wish to highlight this year: 2. Total number of volunteers

More information

4 a (Code: ) (Expenses $ 184,481 including grants of $ ) (Revenue $ 5,645 ) 4 c (Code: ) (Expenses $ 24,587 including grants of $ ) (Revenue $ 0 )

4 a (Code: ) (Expenses $ 184,481 including grants of $ ) (Revenue $ 5,645 ) 4 c (Code: ) (Expenses $ 24,587 including grants of $ ) (Revenue $ 0 ) Form 990 (2013) Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response or note to any line in this Part III............. 1 Briefly describe the organization

More information

SEE SCHEDULE O SEE SCHEDULE O 1,321,367.

SEE SCHEDULE O SEE SCHEDULE O 1,321,367. Form 990 (2011) ERCES SOCIETY, INC. 51-0175253 Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response to any question in this Part III....................................................

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service G The organization may have to use a copy of this return to satisfy state reporting requirements. A For the 2011 calendar year, or tax year

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 99 Return of Organization Exempt From Income Tax OMB No. 1545-47 Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 21 benefit trust or private foundation) Open

More information

OMB No. 1545-0047 Form 990. Return of Organization Exempt From Income Tax. Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code

OMB No. 1545-0047 Form 990. Return of Organization Exempt From Income Tax. Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code OMB. 1545-0047 Form 990 Return of Organization Exempt From Income Tax 2012 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code Department of the Treasury Internal Revenue Service (except

More information

Government Copy. Community Culinary School of Charlotte, Inc. 2401-A Distribution Street Charlotte, NC 28203 704.375.4500

Government Copy. Community Culinary School of Charlotte, Inc. 2401-A Distribution Street Charlotte, NC 28203 704.375.4500 2013 TA RETURN Government Copy Client: Prepared for: 6250 Community Culinary School of Charlotte, Inc. 2401-A Distribution Street Charlotte, NC 28203 704.375.4500 Prepared by: Terry W. Lancaster C. DeWitt

More information

2013 Exempt Organization Business Tax Return prepared for: THE ARC OF COLORADO 1580 LOGAN STREET, #730 DENVER, CO 80203-1942

2013 Exempt Organization Business Tax Return prepared for: THE ARC OF COLORADO 1580 LOGAN STREET, #730 DENVER, CO 80203-1942 201 Exempt Organization Business Tax Return prepared for: THE ARC OF COLORADO 1580 LOAN STREET, #70 DENVER, CO 8020-1942 BENZ SEYFERT & COMPANY, INC. 1620 WASHINTON AVE OLDEN, CO 80401 Form 990 Department

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 99-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

A For the 2011 calendar year, or tax year beginning 10/01 B Check if applicable:

A For the 2011 calendar year, or tax year beginning 10/01 B Check if applicable: Form 99-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service A For the 2011 calendar year, or tax year beginning, 2011, and ending, B Check if applicable: C D Employer Identification Number Address change

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ PUBLIC DISCLOSURE COPY ** PUBLIC DISCLOSURE COPY ** Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(1) of the Internal Revenue Code (except private

More information

Form 990-EZ and supplemental forms and schedules. Sign and date: An officer must sign and date Form 990-EZ on page 4.

Form 990-EZ and supplemental forms and schedules. Sign and date: An officer must sign and date Form 990-EZ on page 4. Federal Filing Instructions 2014 Name(s) as shown on return Your Social Security Number Date to file by: 08-17-2015 Form to be filed: Form 990-EZ and supplemental forms and schedules Sign and date: An

More information

P.O. BOX 3870 360.337.2978 SILVERDALE, WA 98383-3870

P.O. BOX 3870 360.337.2978 SILVERDALE, WA 98383-3870 Form 990 Department of the Treasury Internal Revenue Service OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2014 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Termination Please use IRS label or print or type. See specific Instructions. Return of Organization Exempt From Income Tax Amended return G Gross receipts $ 591,316. Application pending F Name

More information

How To Check If A Charity Is Doing Well

How To Check If A Charity Is Doing Well PUBLIC DISCLOSURE COPY OMB No. 545-47 Form 99 Return of Organization Exempt From Income Tax Under section 5(c), 527, or 4947(a)() of the Internal Revenue Code (except private foundations) 23 Do not enter

More information

2013 Exempt Org. Return prepared for: ATLANTA VOLUNTEER LAWYERS FOUNDATION, INC 235 PEACHTREE ST NE, 1750 N TOWER ATLANTA, GA 30303

2013 Exempt Org. Return prepared for: ATLANTA VOLUNTEER LAWYERS FOUNDATION, INC 235 PEACHTREE ST NE, 1750 N TOWER ATLANTA, GA 30303 2013 Exempt Org. Return prepared for: ATLANTA VOLUNTEER LAWYERS FOUNDATION, INC 235 PEACHTREE ST NE, 1750 N TOWER ATLANTA, GA 30303 FULTON & KOZAK, CPA 7187 JONESBORO RD STE 100A MORROW, GA 30260-2944

More information

Inspection A For the 2014 calendar year, or tax year beginning Jul 1, 2014, and ending Jun 30, 2015

Inspection A For the 2014 calendar year, or tax year beginning Jul 1, 2014, and ending Jun 30, 2015 Form 990 OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2014 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) G Do not enter social security

More information

Inspection A For the 2013 calendar year, or tax year beginning, 2013, and ending, B Check if applicable: C 45-1611066 ROSS, CA 94957 415-386-1200

Inspection A For the 2013 calendar year, or tax year beginning, 2013, and ending, B Check if applicable: C 45-1611066 ROSS, CA 94957 415-386-1200 Form 990 OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2013 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) G Do not enter Social Security

More information

Number and street (or P.O. box if mail is not delivered to street address ) Room /sune E Telephone number ( 601 ) 984-3504 Amended Q nm

Number and street (or P.O. box if mail is not delivered to street address ) Room /sune E Telephone number ( 601 ) 984-3504 Amended Q nm i _. 990 1 Return of Organization Exempt From Income Tax Form Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Department of

More information

l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492179004143

l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492179004143 l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492179004143 Form 990-EZ IN Department of the Treasury Internal Revenue Service Short Form OMB 1545-1150 Return of Organization Exempt From

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c ), 527, or 4947 (a)(1) of the Internal Revenue Code (except black lung benefit

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form Part I Activities & Governance Revenue Expenses Part II Sign Here 990 1 Paid Preparer Use Only Return of Organization Exempt From Income Tax 2013 10 NORTH ST (609)977-0228 City or town, state or province,

More information

U.S. Income Tax Return for an S Corporation

U.S. Income Tax Return for an S Corporation Form 1120S U.S. Income Tax Return for an S Corporation Do not file this form unless the corporation has filed or is attaching Form 2553 to elect to be an S corporation. Information about Form 1120S and

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 PUBLIC DISCLOSURE COPY Return of Organization Exempt From Income Tax OMB 1545-0047 Under section 501, 527, or 4947(1) of the Internal Revenue Code (except private foundations) 2014 Do not enter

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2011 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

H(a) Is this a group return for affiliates? Yes No CHRIS SHIVERS

H(a) Is this a group return for affiliates? Yes No CHRIS SHIVERS IN ABBA Form 990 Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c ), 527, or 4947 (a)(1) of the Internal Revenue Code (except black

More information

4e Total program service expensesl-$ 4,532,833 Form 990 (2011 )

4e Total program service expensesl-$ 4,532,833 Form 990 (2011 ) l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493133036723 OMB 1545-0047 Return of Organization Exempt From Income Tax Form 990 Under section 501 (c), 527, or 4947 ( a)(1) of the Internal

More information

Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax 2011. and endina 06-30-2012

Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax 2011. and endina 06-30-2012 l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492286001092 990.EZ Short Form OMB 1545-1150 Return of Organization Exempt From Income Tax 2011 Form Under section 501 (c), 527, or 4947 (

More information

Paid Preparer's Firm's name (or yours EISNERAMPER LLP Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493130023463.

Paid Preparer's Firm's name (or yours EISNERAMPER LLP Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493130023463. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 934931323463 OMB 1545-47 Return of Organization Exempt From Income Tax Form 99 Under section 51 (c), 527, or 4947 ( a)(1) of the Internal Revenue

More information

U.S. Corporation Income Tax Return For calendar year 2015 or tax year beginning, 2015, ending, 20

U.S. Corporation Income Tax Return For calendar year 2015 or tax year beginning, 2015, ending, 20 Form 1120 Department of the Treasury Internal Revenue Service A Check if: 1a Consolidated return (attach Form 851). b Life/nonlife consolidated return... 2 Personal holding co. (attach Sch. PH).. 3 Personal

More information

en to Public 90-0055128 LEE GRANIS, TREASURER 61 ROLLING GREEN ROAD BETHANY CT 06524-3321 SEE STMT 1 G Gross recbots$ 1,193,928

en to Public 90-0055128 LEE GRANIS, TREASURER 61 ROLLING GREEN ROAD BETHANY CT 06524-3321 SEE STMT 1 G Gross recbots$ 1,193,928 1 11 TEPGROIJP 08/172015 Return of Organization Exempt From Income Tax Form 990 Under section 501 (c), 527, or 4947 (ax1) of the Internal Revenue Code (except private foundations) Department of the Treasury

More information

Paid Preparer ' s Firm 's name (or yours if self-employed), Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493135041513

Paid Preparer ' s Firm 's name (or yours if self-employed), Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493135041513 l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493135041513 OMB No 1545-0047 Return of Organization Exempt From Income Tax Form 990 Under 501 (c), 527, or 4947 ( a)(1) of the Internal Revenue

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2012 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

Instructions for Schedule D (Form 990)

Instructions for Schedule D (Form 990) 2015 Instructions for Schedule D (Form 990) Supplemental Financial Statements Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless otherwise noted.

More information

2008 Schedule D (Form 990) Instructions - Draft April 7, 2008. Schedule D contains a compilation of various financial statement attachments.

2008 Schedule D (Form 990) Instructions - Draft April 7, 2008. Schedule D contains a compilation of various financial statement attachments. Highlights Schedule D contains a compilation of various financial statement attachments. Part I requires information regarding donor advised funds and other similar funds or accounts. This information

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2010 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

The Pennsylvania State University Right-to-Know Law Report May 25, 2012

The Pennsylvania State University Right-to-Know Law Report May 25, 2012 The Pennsylvania State University Right-to-Know Law Report May 25, 2012 This Report is filed in accordance with the provisions of Chapter 15 of the Right-to-Know Law for the Fiscal Year commencing July

More information

Number, street, and room or suite no. If a P.O. box, see the instructions. City or town, state or province, country, and ZIP or foreign postal code

Number, street, and room or suite no. If a P.O. box, see the instructions. City or town, state or province, country, and ZIP or foreign postal code Form 1065 Department of the Treasury Internal Revenue Service A Principal business activity U.S. Return of Partnership Income For calendar year 2015, or tax year beginning, 2015, ending, 20. Information

More information

Instructions for Schedule D (Form 990) Supplemental Financial Statements

Instructions for Schedule D (Form 990) Supplemental Financial Statements 2009 Instructions for Schedule D (Form 990) Supplemental Financial Statements Department of the Treasury Internal Revenue Service Section references are to the Internal 1. That is separately identified

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2014 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax OMB No. 1545-47 Return of Organization Exempt From Income Tax Form 99 Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Do not enter social security numbers

More information

Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support

Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support 2009 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

Internal Revenue And Form 990

Internal Revenue And Form 990 8/22/205 8:5:58 PM 204 Return YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN ATLANTA (36)- 58-0566253 OMB No. 545-0047 Form 990 Return of Organization Exempt From Income Tax Under section 50(c), 527,

More information

U.S. Property and Casualty Insurance Company Income Tax Return. For calendar year 2014, or tax year beginning, 2014, and ending, 20.

U.S. Property and Casualty Insurance Company Income Tax Return. For calendar year 2014, or tax year beginning, 2014, and ending, 20. Form 1120-PC Department of the Treasury Internal Revenue Service A Check if: 1 Consolidated return (attach Form 851). 2 Life-nonlife consolidated return.. 3 Schedule M-3 (Form 1120-PC) attached... U.S.

More information

HUEY & ASSOCIATES, P.C. NON-PROFIT TAX ORGANIZER - 990

HUEY & ASSOCIATES, P.C. NON-PROFIT TAX ORGANIZER - 990 HUEY & ASSOCIATES, P.C. NON-PROFIT TAX ORGANIZER - 990 ORG1 Please fill out the information below unless it is not applicable to your organization. Organization Information: Organization Name: Address:

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax I Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c ), 527, or 4947( a)(1) of the Internal Revenue Code (except

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Foon 990 Return of Organization Exempt From Income Tax Under section SOl (c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundatlona) ~ Do not enter Social Security numbers on this

More information

Form 990 Return of Organization Exempt From Income Tax

Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-47 Form 99 Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 213 Do not enter Social Security

More information

NATIONAL COUNCIL OF YMCAS OF THE USA. 2012 Form 990 for the Year Ended December 31, 2012. Public Disclosure Copy

NATIONAL COUNCIL OF YMCAS OF THE USA. 2012 Form 990 for the Year Ended December 31, 2012. Public Disclosure Copy NATIONAL COUNCIL OF YMCAS OF THE USA 2012 Form 990 for the Year Ended December 31, 2012 Public Disclosure Copy Form 990 (2012) Page 2 Part III Statement of Program Service Accomplishments Check if Schedule

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service A For the 2006 calendar year, or tax year beginning, 2006, and ending, B Check if applicable: C D Employer Identification Number Please use

More information

Club & LSC Financial Management. Jill J. Goodwin, CPA Waugh & Goodwin, LLP jgoodwin@waughgoodwinllp.com

Club & LSC Financial Management. Jill J. Goodwin, CPA Waugh & Goodwin, LLP jgoodwin@waughgoodwinllp.com Club & LSC Financial Management Jill J. Goodwin, CPA Waugh & Goodwin, LLP jgoodwin@waughgoodwinllp.com Form 990 Forms 1099 and W 2 State taxes Other current issues TAX ISSUES Form 990 File Form 990, 990

More information

Other (specify), H Check III-, if the organization is not I Website :

Other (specify), H Check III-, if the organization is not I Website : L c w 0 For, 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c ), 527, or 4947( a)(1) of the Internal Revenue Code

More information

L Year of formation 2001 M State of leoal domicile MS Summary

L Year of formation 2001 M State of leoal domicile MS Summary ii' Form 990 1 Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Department of

More information

8 Contributions and grants (Part VIII, line 1h). 16,168,120 10,663,050. 9 Program service revenue (Part VIII, line 2g). 2,161,299,893 2,152,202,438

8 Contributions and grants (Part VIII, line 1h). 16,168,120 10,663,050. 9 Program service revenue (Part VIII, line 2g). 2,161,299,893 2,152,202,438 lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493316001470 OMB 1545-0047 Return of Organization Exempt From Income Tax Form 990 Under section 501 (c), 527, or 4947( a)(1) of the Internal

More information

X X X X X X X. 14a. 14b. Form 990 (2009) BAA TEEA0103L 02/12/10

X X X X X X X. 14a. 14b. Form 990 (2009) BAA TEEA0103L 02/12/10 Form 990 (2009) RAPHAEL HOUSE OF SAN FRANCISCO, INC. 94-3141608 Page 3 Part IV Checklist of Required Schedules Yes No 1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private

More information

Sample 1023, Application for Recognition of Exemption FILING INSTRUCTIONS

Sample 1023, Application for Recognition of Exemption FILING INSTRUCTIONS Sample 1023, Application for Recognition of Exemption FILING INSTRUCTIONS Remember, on all attachments to have a heading with your PTA s corporation name and EIN (Employer ID Number). Form 1023 (Rev. 12-2011)

More information

QIQN. Sign Here DON RHOADS CFO Type or print name and title.

QIQN. Sign Here DON RHOADS CFO Type or print name and title. add - 0MB No. 15450047 2013 A For the 2013 calendar year, or tax year beginning 7 / 01, 2013, and ending 6 / 30, 2014 B Check if applicable: C 0 Employer Identification Number DAddresschange CITY OF BEVERLY

More information

A For the 2011 calendar year, or tax year beginning, 2011, and ending, D Employer identification number. 27-4205517 Name change

A For the 2011 calendar year, or tax year beginning, 2011, and ending, D Employer identification number. 27-4205517 Name change Form 990-EZ Department of the Treasury Internal Revenue Service A For the 2011 calendar year, or tax year beginning, 2011, and ending, B Check if applicable: C Name of organization D Employer identification

More information

w Z RECEIVED Return of Organization Exempt From Income Tax Sign Use Only Firm'saddress 50 Abele Road, Suite 1001

w Z RECEIVED Return of Organization Exempt From Income Tax Sign Use Only Firm'saddress 50 Abele Road, Suite 1001 Form 990 Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c ), 527, or 4947(aXl) of the Internal Revenue Code (except black lung benefit

More information

c Net income or (loss) from special events and activities (Subtract line 6b from line 6a) 70,712 6c

c Net income or (loss) from special events and activities (Subtract line 6b from line 6a) 70,712 6c l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492074007020 Form 990-EZ IN Department of the Treasury Internal Revenue Service Short Form OMB No 1545-1150 Return of Organization Exempt

More information

Note: Page 1 of 6 Instructions for Form CHAR500 (rev. 2010)

Note: Page 1 of 6 Instructions for Form CHAR500 (rev. 2010) New York State Department of Law (Office of the Attorney General) Charities Bureau - Registration Section Instructions for Form CHAR500 Annual Filing for Charitable Organizations www.charitiesnys.com Contents:

More information

0 BOX 1920 212-840-51 35 OAmended Lions return. or ASSOCIATION print or MONITORING EAU,& /O DGA SECURITY SYSTEMS, INC. 20-8098207

0 BOX 1920 212-840-51 35 OAmended Lions return. or ASSOCIATION print or MONITORING EAU,& /O DGA SECURITY SYSTEMS, INC. 20-8098207 i Form r 990-EZ ^D Return ojb^jw^n a1onxempt From Income Tax Under section 501(c), 527, or 4947( a)(1) of the Internal Revenue Code ( except black lung benefit trust or private foundation) Sponsoring organizations

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) Open to

More information

Instructions for Schedule L (Form 990 or 990-EZ)

Instructions for Schedule L (Form 990 or 990-EZ) 2010 Instructions for Schedule L (Form 990 or 990-EZ) Transactions With Interested Persons Department of the Treasury Internal Revenue Service State whether the transaction has been Section references

More information

D Employer identification number PHEMUS CORPORATION F Address change 04-2997367 Doing Business As F Name change

D Employer identification number PHEMUS CORPORATION F Address change 04-2997367 Doing Business As F Name change l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493135056262 OMB No 1545-0047 Return of Organization Exempt From Income Tax Form 990 Under section 501 ( c), 527, or 4947(a)(1) of the Internal

More information

lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492221000650 1 Contributions, gifts, grants, and similar amounts received 1

lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492221000650 1 Contributions, gifts, grants, and similar amounts received 1 lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492221000650 Form 990-EZ IN Department of the Treasury Internal Revenue Service Short Form OMB No 1545-1150 Return of Organization Exempt From

More information

3706JK K925 11/16/2015 12:59:31 PM V 11-6.5 71302 PAGE 4

3706JK K925 11/16/2015 12:59:31 PM V 11-6.5 71302 PAGE 4 For 99 (211) Page 2 Part III Stateent of Progra Service Accoplishents Check if Schedule O contains a response to any question in this Part III 1 Briefly describe the organization's ission: ATTACHMENT 1

More information

Charities Accounting Standard Accounting Template Explanatory Notes

Charities Accounting Standard Accounting Template Explanatory Notes Charities Accounting Standard Accounting Template Explanatory Notes Introduction Purpose of Accounting Template The Accounting Template is designed to help smaller charities prepare and present financial

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 99 Return of Organization Exempt From Income Tax OMB No. 1545-47 Under section 51(c), 57, or 4947(a)(1) of the Internal Revenue Code (except black lung 1 benefit trust or private foundation) Open

More information

Serving the Non-Profit Industry August 2008. TheNewForm990 Life Under the Microscope for Non-Profits. By Reed W. Risteen, CPA. Partners, Blum Shapiro

Serving the Non-Profit Industry August 2008. TheNewForm990 Life Under the Microscope for Non-Profits. By Reed W. Risteen, CPA. Partners, Blum Shapiro Certified Public Accountants Business Consultants Non-Profit Notes Serving the Non-Profit Industry August 2008 Important Details Regarding Changes to Form 990 UPMIFA Implementation Issues Learn more inside.

More information

Pre pare r Use Only. Paid. efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493052001084. Summary. lijaw Signature Block.

Pre pare r Use Only. Paid. efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493052001084. Summary. lijaw Signature Block. For Paperwork Reduction Act tice, see the separate instructions. efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493052001084 OMB 1545-0047 Return of Organization Exempt From Income Tax Form

More information

Small Business Services 112 Krog Street, Ste# 17 Atlanta, GA 30307 (404) 873-0470 info@smallbizservices.com

Small Business Services 112 Krog Street, Ste# 17 Atlanta, GA 30307 (404) 873-0470 info@smallbizservices.com Small Business Services 112 Krog Street, Ste# 17 Atlanta, GA 30307 (404) 873-0470 info@smallbizservices.com May 16, 2011 Global Soap Project Inc. P.O. Box 94021 Atlanta, GA 30318 Dear John E. Parkerson,

More information

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns June 3 2016 North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns Governor McCrory signed into law Session Law 2016-6

More information

Instructions for Schedule L (Form 990 or 990-EZ)

Instructions for Schedule L (Form 990 or 990-EZ) 2011 Instructions for Schedule L (Form 990 or 990-EZ) Transactions With Interested Persons Department of the Treasury Internal Revenue Service Section references are to the Internal do so, it must file

More information

Exempt Organizations Summary & Comments regarding the New Form 990

Exempt Organizations Summary & Comments regarding the New Form 990 Exempt Organizations Summary & Comments regarding the New Form 990 The Internal Revenue Service has released a draft of the revised Form 990, annual tax return for non profit organizations. The purpose

More information

2013 Tax Organizer People Interested in Giving (PIG) Foundation

2013 Tax Organizer People Interested in Giving (PIG) Foundation 213 Tax Organizer v214.2.17 214 Clark Nuber If you have questions, please contact: Jennifer Becker Harris 425-454-4919 Kathryn Ong 425-454-4919 jharris@clarknuber.com kong@clarknuber.com Links are listed

More information

THE SOUTH FLORIDA CHURCH OF CHRIST, INC.

THE SOUTH FLORIDA CHURCH OF CHRIST, INC. THE SOUTH FLORIDA CHURCH OF CHRIST, INC. FINANCIAL STATEMENTS THE SOUTH FLORIDA CHURCH OF CHRIST, INC. FINANCIAL STATEMENTS TABLE OF CONTENTS PAGES Independent Auditor s Report 1 Statement of Financial

More information

This is not a current year tax form and cannot be used to file a 2009 return. If you use this form for a tax year other than is intended, it will not

This is not a current year tax form and cannot be used to file a 2009 return. If you use this form for a tax year other than is intended, it will not This is not a current year tax form and cannot be used to file a 2009 return If you use this form for a tax year other than is intended, it will not be processed Instead, it will be returned to you with

More information

... 1 2 Program service revenue including government fees and contracts 2 3 Membership dues and assessments..

... 1 2 Program service revenue including government fees and contracts 2 3 Membership dues and assessments.. 990 -^Z Short Form Return of Organization Exempt From Income Tax Form Under section 501(c ), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Sponsoring

More information

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns June 3 2016 North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns Governor McCrory signed into law Session Law 2016-6

More information

Instructions for Form 990-EZ

Instructions for Form 990-EZ 2013 Instructions for Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under Section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

24465 22 22553 23 Land and buildings... 23 24 Other assets (describe INSTRUMENTS MUSIC UNIFORMS TRAILER ) 8000 24 9605

24465 22 22553 23 Land and buildings... 23 24 Other assets (describe INSTRUMENTS MUSIC UNIFORMS TRAILER ) 8000 24 9605 all) 0 0N -44 Short Form Return of Organization Exempt From Income Tax 990^F1 Form Under section 501 (c), 527, or 4947( a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

More information

13 Professional fees and other payments to independent contractors... 13 7,000... 14 20,358

13 Professional fees and other payments to independent contractors... 13 7,000... 14 20,358 CU c%j Fom, 990 ^EZ Short Form Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947 (a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

More information

The Revised Form 990: Do s, Don ts, and Best Practices. Background Why the Change?

The Revised Form 990: Do s, Don ts, and Best Practices. Background Why the Change? The Revised Form 990: Do s, Don ts, and Best Practices Brought to you by CBIZ MHM, LLC Presented by Brenda A. Blunt Background Why the Change? The form 990 has not been significantly revised since 1979

More information

FINANCIAL REPORTING GUIDELINES

FINANCIAL REPORTING GUIDELINES FINANCIAL REPORTING GUIDELINES These policies support and extend COMTA Accreditation Standard XII. As such, institutions must demonstrate compliance to both. STATEMENT OF PURPOSE: All new institutional

More information

Governance and Related Topics - 501(c)(3) Organizations

Governance and Related Topics - 501(c)(3) Organizations Governance and Related Topics - 501(c)(3) Organizations The Internal Revenue Service believes that a well-governed charity is more likely to obey the tax laws, safeguard charitable assets, and serve charitable

More information

Source data is a custom data export provided by the IRS Exempt Organizations Projects Department.

Source data is a custom data export provided by the IRS Exempt Organizations Projects Department. About the Data The reports in this presentation contain aggregate financial information from the Form 990 (or the long form 990) that organizations reported to the Internal Revenue Service (IRS) for their

More information

Highlights of IRS Form 990

Highlights of IRS Form 990 Highlights of IRS Form 990 IRS Form 990 contains a wealth of information far too much to discuss in a quick overview. Here, however, is a review of the parts of the form as well as an introduction to several

More information

The Public Support Test What a Grant Seeker Should Know

The Public Support Test What a Grant Seeker Should Know I. Overview: Why Public Support is Important The Public Support Test What a Grant Seeker Should Know Organizations that seek grants from foundations are usually principally interested in obtaining the

More information

GIFT ACCEPTANCE POLICY

GIFT ACCEPTANCE POLICY GIFT ACCEPTANCE POLICY Nutrition Science Initiative, a California public benefit corporation ("NuSI") located in San Diego, California, encourages the solicitation and acceptance of gifts to NuSI for purposes

More information

How to Avoid Ten IRS Land Mines for Nonprofit Charities

How to Avoid Ten IRS Land Mines for Nonprofit Charities How to Avoid Ten IRS Land Mines for Nonprofit Charities The drive to increase revenue leads many nonprofit organizations to start up business activities. Easy profits are expected, but tax traps waiting

More information

01^ 1k 990-EZ. ated 12-11 43RD AVENUE 718-361-0145 1 13141020 759639 PMT77017.04 2009.04050 UNITED UNION OF ROOFERS - L PMT77011.

01^ 1k 990-EZ. ated 12-11 43RD AVENUE 718-361-0145 1 13141020 759639 PMT77017.04 2009.04050 UNITED UNION OF ROOFERS - L PMT77011. i m O Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code ( except

More information

FINANCIAL MANAGEMENT POLICIES AND PROCEDURES

FINANCIAL MANAGEMENT POLICIES AND PROCEDURES FINANCIAL MANAGEMENT POLICIES AND PROCEDURES SAMPLE 1. GENERAL PURPOSE The purpose of these policies is to establish guidelines for developing financial goals and objectives, making financial decisions,

More information

Pace & Hawley, LLC Certified Public Accountants

Pace & Hawley, LLC Certified Public Accountants Pace & Hawley, LLC Certified Public Accountants Form 990 Return of Organization Exempt From Income Tax Robert Pace, CPA, - Nathan Hawley, CPA PO Box 603 - Montpelier, VT 05601 TEL (802) 461-2587 - FAX

More information